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C-Brace II Spinal Cord Injury

Primary Purpose

Spinal Cord Injury

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
C-Brace II
Traditional Care KAFO intervention
Sponsored by
Shirley Ryan AbilityLab
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Spinal Cord Injury focused on measuring Orthotic, C-Brace

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

All participants:

Inclusion Criteria:

  • Be within 3-24 months post spinal cord injury diagnosis
  • 18-80 years
  • Must be able to demonstrate the ability to charge assigned sensors during 3-month home trial period on and off and sufficient memory ability to wear the devices each day during use of the orthoses.

Exclusion Criteria:

  • Unstable neurological, cardiovascular, or cancer diagnoses.
  • Cognitive impairments that limit study participation

In addition to the above inclusion criteria, the following criteria must be met to be designated into the study interventional tract (C-Brace II):

Inclusion criteria:

  • Requires orthotic bracing for lower extremity instability, including the knee joint, unilaterally or bilaterally

Exclusion criteria:

  • Body weight over 275 lbs
  • Flexion contracture in the knee and/or hip joint in excess of 10 degrees
  • Non-correctable knee varus/valgus in excess of 10 degrees
  • Moderate to severe spasticity
  • Leg length discrepancy in excess of 6" (15.24 cm)
  • Inability to stabilize the trunk with or without assistive devices (crutches, cane, etc.)
  • Inability to successfully use C-Brace trial tool in advancement of leg/s.

Sites / Locations

  • Shirley Ryan AbilityLabRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

C-Brace II Group

Traditional Group

Arm Description

Subjects will be assigned a C-Brace II orthotic for use.

Subjects will continue with their own KAFO (non C-Brace II) use.

Outcomes

Primary Outcome Measures

Six Minute Walk Test (6MWT)
The test measures the distance that the patient can walk on a flat, hard surface, indoors, in a period of 6 minutes. The walk test is patient self-paced and assesses the level of functional capacity. Patients are allowed to stop and rest during the test, however, the timer does not stop. If the patient is unable to complete the time, the time stopped is noted and reason for stopping prematurely is recorded. This test will be administered while wearing a mask to measure oxygen consumption.

Secondary Outcome Measures

Muscle Strength (manual muscle test)
Muscle strength will be assessed by a trained clinical researcher
Passive and Active Range of Motion of Lower Extremity joints
Modified Ashworth Scale
A scale used to measure the amount of tone in individuals with neurologic diagnoses. Tone is scored by passively moving the individual's limb and assessing the amount of resistance to movement felt by the examiner.
10 Meter Walk Test (10MWT)
This test will examine the patient's gait speed. Patients will be positioned 1 meter before the start line and instructed to walk the entire 10 meter distance and past the end line approximately 1 meter. The distance before and after the course are meant to minimize the effect of acceleration and deceleration. Time will be recorded using a stopwatch and recorded to the one hundred of a second (ex: 2.15 sec). The test will be recorded 6 times: 3 times at the patient's self-selected speed, and 3 times at the patient's quickest, yet safest speed. The average of each of the 3 times will be recorded. Adequate rest in between trials will be given.
Walking Index for Spinal Cord Injury (WISCI II)
A rank ordering along a dimension of impairment, from the level of most severe impairment (0) to least severe impairment (20) based on the use of devices, braces, and physical assistance of one or more persons.
Functional Gait Assessment (FGA)
The Functional Gait Assessment is a 10 item test used to assess postural stability during walking tasks. It has a maximum score of 30 with each item being scored 0-3. It may be performed with or without an assistive device; however, individuals lose a point on all items requiring a device.
Berg Balance Scale (BBS)
The Berg Balance Scale is a 14-item scale designed to measure balance in adults in a clinical setting. When scoring, the lowest response category that applies should be recorded. In each item, points should be deducted if the time or distance requirements are not met, the subject's performance requires supervision, or the subject requires assistance from support or examiner.
Timed Up and Go test (TUG)
A test which times the ability of a patient to stand up from a standard chair with arm rests, walk 3 meters forward, turn around, walk 3 meters back to the chair, and sit back down in the chair.
Gaitrite data capture
The Gaitrite system automates measuring temporal and spatial gait parameters via an electronic walkway connected to a computer. The Gaitrite electronic walkway contains sensor pads encapsulated in a carpet to collect gait information. The system can be laid over any flat surface. The Gaitrite electronic walkway for the study shall be a minimum of 14 feet long. The Gaitrite data capture was chosen as measurement of the patient's overall gait quality. Patients will be asked to walk at a self-selected speed across the Gaitrite electronic walkway.

Full Information

First Posted
April 25, 2019
Last Updated
October 24, 2022
Sponsor
Shirley Ryan AbilityLab
Collaborators
Otto Bock Healthcare Products GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT03930056
Brief Title
C-Brace II Spinal Cord Injury
Official Title
Micro-Processor Controlled Knee-Ankle-Foot Orthosis (C-Brace) Usage in a Spinal Cord Injury (SCI) Population Compared to Traditional Rehabilitation Methods: Determining Functional Outcome Differences of Recovery
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
April 16, 2019 (Actual)
Primary Completion Date
November 2025 (Anticipated)
Study Completion Date
November 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Shirley Ryan AbilityLab
Collaborators
Otto Bock Healthcare Products GmbH

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
A randomized, repeated measures comparative design study to compare use of a micro-processor controlled knee-ankle-foot orthosis vs. traditional care knee-ankle-foot-orthosis (KAFO) models following discharge from inpatient rehabilitation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spinal Cord Injury
Keywords
Orthotic, C-Brace

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
C-Brace II Group
Arm Type
Experimental
Arm Description
Subjects will be assigned a C-Brace II orthotic for use.
Arm Title
Traditional Group
Arm Type
Active Comparator
Arm Description
Subjects will continue with their own KAFO (non C-Brace II) use.
Intervention Type
Device
Intervention Name(s)
C-Brace II
Intervention Description
Participant will complete 3-6 orthoses sessions to complete clinical evaluations and fittings conducted by certified orthotists. Participant will receive 10-20, one hour training sessions over 1-2 months in the lab. These sessions include tuning the device and system tweaks in accordance to needs/preferences of participant, vitals signs, skin checks, pain, and exertion levels. Sessions involve training with the device, which includes putting on / taking off the device, transfer training, gait training, and balance and fall prevention. Up to 20 sessions will be conducted until minimum safety guidelines are reached during a minimum of at least 3 training sessions in a row. Participant will take the assigned device home to use for a 3-month period. Participant will be given an activity monitor to wear at all times except showering and instructed how to charge the device and use it. Participant will return for testing at 3, 6 and 12 months after receiving the brace for testing.
Intervention Type
Device
Intervention Name(s)
Traditional Care KAFO intervention
Intervention Description
Participant will continue with use of their own KAFO. Participant will receive 10-20, one hour training sessions over 1-2 months in the lab, if Patient is not already receiving care in a therapy setting. These sessions include tuning the device and system tweaks in accordance to needs/preferences of participant, vitals signs, skin checks, pain, and exertion levels. Sessions involve training with the device, which includes putting on / taking off the device, transfer training, gait training, and balance and fall prevention. Up to 20 sessions will be conducted until minimum safety guidelines are reached during a minimum of at least 3 training sessions in a row. Participant will continue with the assigned device home to use for a 3-month period. Participant will be given an activity monitor to wear at all times except showering and instructed how to charge the device and use it. Participant will return for testing at 3, 6 and 12 months after receiving the brace for testing.
Primary Outcome Measure Information:
Title
Six Minute Walk Test (6MWT)
Description
The test measures the distance that the patient can walk on a flat, hard surface, indoors, in a period of 6 minutes. The walk test is patient self-paced and assesses the level of functional capacity. Patients are allowed to stop and rest during the test, however, the timer does not stop. If the patient is unable to complete the time, the time stopped is noted and reason for stopping prematurely is recorded. This test will be administered while wearing a mask to measure oxygen consumption.
Time Frame
Change from baseline in 6MWT distance after using device at 3, 6, and 12 month follow-up.
Secondary Outcome Measure Information:
Title
Muscle Strength (manual muscle test)
Description
Muscle strength will be assessed by a trained clinical researcher
Time Frame
Change from baseline in muscle strength after using device at 3, 6, and 12 month follow-up.
Title
Passive and Active Range of Motion of Lower Extremity joints
Time Frame
Change from baseline in range of motion after using device at 3, 6, and 12 month follow-up.
Title
Modified Ashworth Scale
Description
A scale used to measure the amount of tone in individuals with neurologic diagnoses. Tone is scored by passively moving the individual's limb and assessing the amount of resistance to movement felt by the examiner.
Time Frame
Change from baseline in muscle tone after using device at 3, 6, and 12 month follow-up.
Title
10 Meter Walk Test (10MWT)
Description
This test will examine the patient's gait speed. Patients will be positioned 1 meter before the start line and instructed to walk the entire 10 meter distance and past the end line approximately 1 meter. The distance before and after the course are meant to minimize the effect of acceleration and deceleration. Time will be recorded using a stopwatch and recorded to the one hundred of a second (ex: 2.15 sec). The test will be recorded 6 times: 3 times at the patient's self-selected speed, and 3 times at the patient's quickest, yet safest speed. The average of each of the 3 times will be recorded. Adequate rest in between trials will be given.
Time Frame
Change from baseline in gait speed after using device at 3, 6, and 12 month follow-up.
Title
Walking Index for Spinal Cord Injury (WISCI II)
Description
A rank ordering along a dimension of impairment, from the level of most severe impairment (0) to least severe impairment (20) based on the use of devices, braces, and physical assistance of one or more persons.
Time Frame
Change from baseline in rank score after using device at 3, 6, and 12 month follow-up.
Title
Functional Gait Assessment (FGA)
Description
The Functional Gait Assessment is a 10 item test used to assess postural stability during walking tasks. It has a maximum score of 30 with each item being scored 0-3. It may be performed with or without an assistive device; however, individuals lose a point on all items requiring a device.
Time Frame
Change from baseline in FGA score after using device at 3, 6, and 12 month follow-up.
Title
Berg Balance Scale (BBS)
Description
The Berg Balance Scale is a 14-item scale designed to measure balance in adults in a clinical setting. When scoring, the lowest response category that applies should be recorded. In each item, points should be deducted if the time or distance requirements are not met, the subject's performance requires supervision, or the subject requires assistance from support or examiner.
Time Frame
Change from baseline in Berg Balance score after using device at 3, 6, and 12 month follow-up.
Title
Timed Up and Go test (TUG)
Description
A test which times the ability of a patient to stand up from a standard chair with arm rests, walk 3 meters forward, turn around, walk 3 meters back to the chair, and sit back down in the chair.
Time Frame
Change from baseline in TUG score after using device at 3, 6, and 12 month follow-up.
Title
Gaitrite data capture
Description
The Gaitrite system automates measuring temporal and spatial gait parameters via an electronic walkway connected to a computer. The Gaitrite electronic walkway contains sensor pads encapsulated in a carpet to collect gait information. The system can be laid over any flat surface. The Gaitrite electronic walkway for the study shall be a minimum of 14 feet long. The Gaitrite data capture was chosen as measurement of the patient's overall gait quality. Patients will be asked to walk at a self-selected speed across the Gaitrite electronic walkway.
Time Frame
Change from baseline in gait parameters after using device at 3, 6, and 12 month follow-up.
Other Pre-specified Outcome Measures:
Title
Activities Specific Balance Confidence Scale (ABC)
Description
The ABC Scale is a self-report questionnaire consisting of 16 items designed to measure fear of falling. It assesses an individual's perception of balance during activities of daily living by asking the individual to rate their confidence during different activities on a 0% (no confidence) to 100% (completely confident) scale.
Time Frame
Change from baseline in score after using device at 3, 6, and 12 month follow-up.
Title
Modified Falls Efficacy Scale (mFES)
Description
The mFES is self-report questionnaire consisting of 14 items which is designed to measure fear of falling in the elderly. It assesses an individual's perception of balance during activities of daily living by asking "how confident are you that you can do the following activities without falling."
Time Frame
Change from baseline in score after using device at 3, 6, and 12 month follow-up.
Title
Spinal Cord Injury Quality of Life (SCI-QOL)
Description
The SCI-QOL are a battery of self-reported questionnaires completed by participants to evaluate perceptions of personal independence, ability to communicate needs with others, and sense of control over one's life in individuals with spinal cord injury.
Time Frame
Change from baseline in score after using device at 3, 6, and 12 month follow-up.
Title
EQ5D-5L
Description
A self-reported, health related, quality of life questionnaire. It measures quality of life in 5-components including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each level is rated on a scale describing the degree of problems in that area. It ends with an overall health scale between 1-100 to rate the level of health the user is experiencing at the time of the test.
Time Frame
Change from baseline in score after using device at 3, 6, and 12 month follow-up.
Title
Orthotics and Prosthetics User Survey (OPUS)
Description
The Orthotic and prosthetics User Survey is a self-report questionnaire which is designed to evaluate the outcome of orthotic and prosthetic services. We will administer three of the five domains: lower limb functional measure, health-related quality of life, and satisfaction with device. The domains of upper limb functional measure and satisfaction with service are not applicable in this study.
Time Frame
Change from baseline in score after using device at 3, 6, and 12 month follow-up.
Title
World Health Organization Quality of Life (WHOQOL-BREF)
Description
The WHOQOL-BREF is a self-report questionnaire that measures an individual's perceived quality of life. It contains four domains which cover physical health, psychological health, social relationships, and environment. Scores range from 0-100 with 100 indicating a higher quality of life. The scores can be broken down by domain or taken as a whole. The WHOQOL-BREF is valid cross-culturally.
Time Frame
Change from baseline in score after using device at 3, 6, and 12 month follow-up.
Title
International Spinal Cord Injury Bowel Function Data Set
Description
The purpose of this test is to standardize collection and reporting on the bowel in individuals with spinal cord injury. Questions include bowel care procedures, surgical procedures, time, frequency, and method of bowel practices.
Time Frame
Change from baseline in score after using device at 3, 6, and 12 month follow-up.
Title
International Spinal Cord Injury Lower urinary Tract Basic Data Set
Description
The purpose of this test is to standardize collection and reporting of information on the lower urinary tract in individuals with spinal cord injury. Questions include surgical procedures, drugs, bladder emptying, and incontinence. These are used by clinicians and researchers so that data can be shared and combined easily.
Time Frame
Change from baseline in score after using device at 3, 6, and 12 month follow-up.
Title
Spinal Cord Injury Bowel and Bladder Treatment Index Short Form (SCI-BBTI-SF)
Description
A self-report questionnaire that assesses bowel and bladder function. It includes items regarding bowel and bladder emptying habit, complications from SCI-related surgery, assistance required, and perceived quality of life.
Time Frame
Change from baseline in score after using device at 3, 6, and 12 month follow-up.
Title
Actigraph
Description
The Actigraph is a small accelerometer worn on a body part which can identify performance of functional activities during use.
Time Frame
Change from baseline measurement after using device at 3, 6, and 12 month follow-up.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
All participants: Inclusion Criteria: Be within 3-24 months post spinal cord injury diagnosis 18-80 years Must be able to demonstrate the ability to charge assigned sensors during 3-month home trial period on and off and sufficient memory ability to wear the devices each day during use of the orthoses. Exclusion Criteria: Unstable neurological, cardiovascular, or cancer diagnoses. Cognitive impairments that limit study participation In addition to the above inclusion criteria, the following criteria must be met to be designated into the study interventional tract (C-Brace II): Inclusion criteria: Requires orthotic bracing for lower extremity instability, including the knee joint, unilaterally or bilaterally Exclusion criteria: Body weight over 275 lbs Flexion contracture in the knee and/or hip joint in excess of 10 degrees Non-correctable knee varus/valgus in excess of 10 degrees Moderate to severe spasticity Leg length discrepancy in excess of 6" (15.24 cm) Inability to stabilize the trunk with or without assistive devices (crutches, cane, etc.) Inability to successfully use C-Brace trial tool in advancement of leg/s.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Arun Jayaraman, PT, PhD
Phone
312-238-6875
Email
ajayaraman@sralab.org
First Name & Middle Initial & Last Name or Official Title & Degree
Lori McGee-Koch
Phone
312-238-2091
Email
lmcgee@sralab.org
Facility Information:
Facility Name
Shirley Ryan AbilityLab
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lori McGee-Koch
Phone
312-238-2091
Email
lmcgee@sralab.org

12. IPD Sharing Statement

Learn more about this trial

C-Brace II Spinal Cord Injury

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